Marshall R D, Schneier F R, Lin S H, Simpson H B, Vermes D, Liebowitz M
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Am J Psychiatry. 2000 Mar;157(3):451-3. doi: 10.1176/appi.ajp.157.3.451.
Childhood trauma has been associated with increased risk for both panic disorder and dissociative symptoms in adulthood. The authors hypothesized that among individuals with a primary diagnosis of panic disorder, those experiencing depersonalization/derealization during panic attacks would be more likely to have a history of childhood trauma.
Rates of traumatic events were compared between panic disorder patients with (N=34) and without (N=40) prominent depersonalization/derealization during panic attacks. Symptom severity in the two groups was also examined.
Contrary to the authors' hypothesis, no evidence was found that depersonalization/derealization during panic attacks was associated with childhood trauma. Minimal differences in severity of illness were found between patients with dissociative symptoms and those without such symptoms.
This finding is consistent with a multifactorial model of dissociation. Factors other than childhood trauma and general psychopathology may underlie vulnerability to dissociative symptoms in panic disorder.
童年创伤与成年期惊恐障碍和分离症状的风险增加有关。作者推测，在以惊恐障碍为主要诊断的个体中，在惊恐发作期间经历人格解体/现实解体的人更有可能有童年创伤史。
比较了在惊恐发作期间有（N = 34）和没有（N = 40）明显人格解体/现实解体的惊恐障碍患者的创伤事件发生率。还检查了两组的症状严重程度。
与作者的假设相反，没有发现证据表明惊恐发作期间的人格解体/现实解体与童年创伤有关。有分离症状的患者和没有此类症状的患者在疾病严重程度上的差异很小。
这一发现与分离的多因素模型一致。童年创伤和一般精神病理学以外的因素可能是惊恐障碍中分离症状易感性的基础。
